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Topic: The Public Option (Read 8369 times)

As a physician practicing public health for the last 22 years, I have seen countless folks who have lost their lives or health, and prosperity due to

1. pre-existing illness2. losing their job3. inadequate coverage via their insurance4. and, of course, not being able to afford insurance.

A government-managed option like Medicare, Medicaid, or Veterans Administration benefits is very, very important in the new healthcare plan.

Please don't let the proponents of scare tactics and misinformation win this one and deprive Americans of a government option for insurance.

Remember the insurance and pharmaceutical industry are heavily funding the hatchet job on the public option. The reason is, of course, money.

There are no death panels, no threats to existing programs, no loss of choice of physician, and no rationing of healthcare.

Sign the petition and consider a contribution to the effort. As you know, I never, ever send out solicitation emails, but I feel like this is a critical time for a crucial issue with which I am all too familiar.

Good luck with this. I've seen a great deal of what I'd call criminal misrepresentation of our system (and that of the UK) in the US media. It is by no means perfect and morally and ethically compromised ideologues on this side of the border are also trying to undermine the ideal of public healthcare. But they are always connected to financial interests. Always. However, knowing many on both sides who've been through both systems I'll say that the public option works just fine.

Funny how the rest of the civilized world has "socialized medicine," and in the US the Armed Forces, the Postal Service, Medicare, and Social Security are all run by the government, but a public healthcare option would amount to political elites kicking in our doors and taking our guns.

However Obama mentioned something I haven't heard anybody talk about which is that with his healthcare reform, even though it costs around a trill, will somehow reduce the debt by $4 trillion over time. Obamanomics?

Repubs have pointed out several times that with the public option businesses will stop providing insurance and pass the cost onto the government. How true is this? I believe its a law now that they have to provide insurance. Would that still stand?

Steve

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This is good! This is an issue that is more complicated than the politicians or the people in front of TV cameras make it seem. Discussions like this are important. Hopefully, this one won't evolve into the name calling and personal attacks that usually accompany political debates on forums. Just my $.02 . Harry

This is good! This is an issue that is more complicated than the politicians or the people in front of TV cameras make it seem. Discussions like this are important. Hopefully, this one won't evolve into the name calling and personal attacks that usually accompany political debates on forums. Just my $.02 . Harry

I've been on COBRA for 18 months now and the public option is the only option for people like me. My current employer does not offer insurance and I've been denied 3 times in the last couple months due to pre-existing conditions even though I've been insured pretty much all my life. I am fortunate, however, to live in apparently the only state with a "public option". I've discovered that Colorado has a program that extends affordable coverage to those who can't afford insurance, have been denied and/or exhausted all options. I have yet to be enrolled and use it but I am hoping it proves to be a financial life saver!

I have heard from a few people who were advised (along with myself) that if I can't get medical coverage that I should get a divorce, hide my money, go on disability & welfare and acquire Medicaid. So, for the right wingers who think this is bogus, I find it highly hypocritical to oppose a public option vs. the break up on a holy marriage, lie and hide money, and ultimately obtain government assisted health care!

There are so many lies and exaggerations surrounding this subject and I'm glad Obama is standing up against it all.

I post pretty frequently (also as cromag) on another board, run by a local public radio station. There is one person in particular over there who has a remarkably twisted world view (IMHO) and he started a thread similar to this as a way to further his agenda. I'll copy my post from there, since it says pretty much all I want to say on the subject. (My apologies in advance to anyone who might be offended by my choice of words -- especially my European friends -- I was just trying to make a point.)

Quote from: cromag

I have been hearing since the 60s about how our car manufacturers, steel producers, etc., are at a huge competitive disadvantage because they have to cover health costs while their competitors in Europe and Asia don't -- their governments cover health care.

And in those 40 years the American automobile industry has crumbled, our steel producers have disappeared, etc. General Motors has gone bankrupt, Fiat now owns the remains of Chrysler, etc.

Every year health care becomes more expensive. Since it is more expensive, every year fewer companies can afford to offer any kind of health care as an employment benefit. Every year more Americans -- even those with jobs -- lose their insurance, or take substandard insurance with inadequate coverage, unrealistic limits, extremely high deductibles, and no coverage of pre-existing conditions.

Since more people lose their coverage each year, more people turn to hospital emergency rooms as their "primary care physician" each year -- overwhelming their staffs, making them less accessible to people who have real, life-threatening emergencies, driving private hospitals into bankruptcy and transferring their health care costs to taxpayers or charities. Emergency rooms, meanwhile, will only "stabilize" patients, meaning chronic conditions will become worse: children will lose more days of school than they have to, and parents risk their jobs (and whatever health care benefit they might have) to stay home with them.

And each year it gets worse. Here in America, that is.

Meanwhile, our health care industry is regarded with horror by other countries.

Europeans are not stupid, and they are not subject to ruthless dictatorships. If they were getting inadequate health care, if their grannies were being killed, or if their taxes were intolerable, they'd have said something in the past 40 years -- these are, after all, people who call national strikes if the government threatens to reduce their five weeks of summer vacation. If their doctors (many of whom were educated in America) couldn't make a decent living they'd be leaving -- instead, it's American doctors who are leaving their fields and creating critical shortages in medical specialties.

Here in America we have the most expensive health care, per capita, in the industrial world -- yet, in terms of life expectancy, we rank somewhere between 30th and 45th ( see <HERE>).

How stupid are we?

There will always be people who are afraid of change -- but it would be stupid to let them lead. Horses do run back into burning barns -- but it would be stupid to follow them. As expensive as health care is, stupidity is always more expensive.

I am not going to get into this one, primarily because I have been overcome with an "I really couldn't give a shit" attitude about the whole thing. I did watch TV aver the weekend (GASP!) and saw something interesting. A speech made at a Tea Party in DC in which the closing line was "God Bless the USA, and God Bless FOX News."

Proponents of the public option often blame the greedy insurance companies as the main culprit for the healthcare crisis. You hear stories of how people are denied coverage and so on, and how the government will step in and offer a competetive, which by default means cheaper than present insurance plan.

But why hasn't an insurance company done this already? Why wouldn't a company in this case try to undercut their competition and gain a better hold on their market in some way?

My understanding of the marketplace is that greed will have companies lower their prices, increase efficiency, and please their customer to the extent in which they can gain the most customers possible, which is a good thing for both sides... so what's stopping a health insurance company?

My understanding of the marketplace is that greed will have companies lower their prices, increase efficiency, and please their customer to the extent in which they can gain the most customers possible, which is a good thing for both sides... so what's stopping a health insurance company?

Greed does not have anything to do with a healthy market. A system greased by greed attracts chancers, sociopaths and scum...which is what we have. Therefore systems are subverted and perverted to satisfy the strong willed among them and lower the resistance of the weak.

My understanding of the marketplace is that greed will have companies lower their prices, increase efficiency, and please their customer to the extent in which they can gain the most customers possible, which is a good thing for both sides... so what's stopping a health insurance company?

Greed does not have anything to do with a healthy market. A system greased by greed attracts chancers, sociopaths and scum...which is what we have. Therefore systems are subverted and perverted to satisfy the strong willed among them and lower the resistance of the weak.

Maybe I should replace the word greed with another word: competition. It's in the self interest of a company to sell the best product at the lowest possible price. It's not out of some altruistic notion that we have lower prices of cell phones, flat-screen TVs, and other products that years ago cost so much more, as I'm sure you'll agree. In almost every industry that has no unfair restrictions to competition imposed on it, the prices generally come down and the quality generally goes up.

But my simple question is what's stopping a competetive insurance company from entering into the marketplace of today and doing what the government wants to do, which is offer a lower price? Imagine all the customers they'd get... Don't you think it would be in the self interest of companies to be doing that?

It's in the self interest of a company to sell the best product at the lowest possible price. It's not out of some altruistic notion that we have lower prices of cell phones, flat-screen TVs, and other products that years ago cost so much more, as I'm sure you'll agree. In almost every industry that has no unfair restrictions to competition imposed on it, the prices generally come down and the quality generally goes up.

But my simple question is what's stopping a competetive insurance company from entering into the marketplace of today and doing what the government wants to do, which is offer a lower price? Imagine all the customers they'd get... Don't you think it would be in the self interest of companies to be doing that?

It would be in the enlightened self-interest to do so. That's not what we have in our society. Insurance companies are, by their nature, extremely risk averse. Add to that a bunch of shareholders wanting quick returns and it's all over for "enlightenment" or social good.

And I disagree entirely with the better goods at lower cost theory. We are awash in junk electronics with short lives made in China. I can't count the number of products I've seen go downhill in quality once mfg is moved offshore while prices remain steady. And cel-phones? Please! You must be joking!

The only US company I really respect in terms of maintenance of quality manufacturing is...Smith & Wesson.

Because health insurance is expensive, many people seem to believe it's because health insurance companies are earning increasing profits. This is generally not true. Health insurance company profits are generally down, in some cases dramatically so.

How can this be, if they're charging much more for health insurance every year? It's because the cost of covering the health care of Americans is rising much faster than the increase in health insurance premiums. There are several reasons for this.

1. There is a huge increase in the number of uninsured or indigent people using emergency rooms for basic health care because emergency room rules prevent hospitals from turning people away due to inability to pay. This is the most expensive way of treating these people, but because these people know they won't have to pay, they have no incentive (other than absurdly long waiting times) to avoid using the emergency room this way. Because the hospital is stuck providing these services without being paid by either the patient or an insurance company, these costs are spread out to other services provided by those who can pay: insurance companies, or honorable uninsured people who go to the hospital and pay the bills out of their own pocket. I was told by someone I know who spoke to a large Portland hospital that he believes medical care costs at least 30% more than it should due to this kind of emergency room "free pass" utilization. In other words, when you have a $5,000 shoulder surgery, it really should only cost $3350 or so, but the hospital has to add $1650 to cover all the deadbeats they have to treat.

2. Insured individuals tend to over-utilize doctors and hospitals. I know several people who go to the doctor 15 or 20 or even 30 times per year, simply because it's virtually free for them to do so. To them, a visit to the doctor isn't $400, it's $20, and a medication isn't $90, it's $15. If they were paying the "real" cost of utilizing these services or medications, they would not go as often, but some actually feel "Well, I'm paying for this insurance so I'm sure going to use it" and not only go more often than if they had to pay for the doctor visit, they actually go more than they would if medical care and insurance were free.

3. Treatments are becoming more exotic, and patients will not stand for anything less than the best. When it comes to choosing cars or homes or clothing, many people will make more economical choices, but when it comes to repairing their child's brain injury, or their own heart valve problem, or especially problems like cancer and HIV, everyone wants the most advanced option available. You can't really blame people for this, but as treatment options (equipment, drugs, analytical tools) become more exotic and expensive, the range of treatments become more expensive. This is more true when it comes to serious illnesses or injuries as I mentioned above, but treatment options even for less significant problems are more expensive than ever, and generally nobody wants to skip the MRI due to cost and just stick with an x-ray, at least if they're insured.

4. The risk of lawsuit for medical malpractice is so high that malpractice insurance eats up a gigantic portion of each doctor's and hospital's income. Anecdotally, I heard that one local psychiatrist earned over $400,000 per year, a tidy profit minus $20,000 per year for office rental and $150,000 per year for malpractice insurance. Holy crap! Obviously this doctor could charge less for his services if he eliminated or reduced the malpractice insurance. In other countries, malpractice lawsuits are a much smaller part of the picture, or even nonexistent.

5. Americans in general are eating too many calories, too much sugar, not exercising enough, smoking too much, drinking too much alcohol, getting too fat, and these problems are becoming worse very quickly. People with these problems have more health problems, both trivial and serious, and require more hospitalization, more surgery, more ambulance rides, and by a huge margin more prescription drugs, than ever before.

The average American's health care expenditures have increased over the years, and as more and more people are uninsured, the average per-person cost for the insured rises even more dramatically, even adjusted for inflation. The ironic thing is that everyone thinks the health insurance companies, the hospitals and the doctors are all getting filthy rich, keeping 90% of what they bring in, and while there are some profits being made, it's nothing like what people think.

It would be in the enlightened self-interest to do so. That's not what we have in our society. Insurance companies are, by their nature, extremely risk averse. Add to that a bunch of shareholders wanting quick returns and it's all over for "enlightenment" or social good.

So if the government is going to step in and "force insurance companies to be competetive", by making them less risk averse, though they are "by nature risk averse,", then how will they continue to exist?

And I disagree entirely with the better goods at lower cost theory. We are awash in junk electronics with short lives made in China. I can't count the number of products I've seen go downhill in quality once mfg is moved offshore while prices remain steady. And cel-phones? Please! You must be joking

I'm not sure the proliforation of shitty products doesn't mean the overall quality of products goes down, or that prices stay the same. Also it is the people, too, who are free to reject a product and not buy it, if they are not willing to live with the quality. My aunt had a VCR with a wired remote control in the 80's! You can get some Blackberry phones now for 200 dollars, but old cellphones would sell for over $1000. Take a look at some of the old cellphones: Maybe the quality of the older cellphones was better in terms of durability, but obviously people value practicality, or else you'd choose the clunkier, perhaps better made varieties. And if something goes down in quality in the short term, and enough people are demanding something else (since quality is a subjective), you can bet another brand will step in and try to fill the need- lowest price possible at best quality.

I'm not sure the proliforation of shitty products doesn't mean the overall quality of products goes down, or that prices stay the same. Also it is the people, too, who are free to reject a product and not buy it, if they are not willing to live with the quality.

I just bought a hacksaw at my local hardware store. I had the "choice" between:

1. shitty2. slightly less shitty3. almost passable for occasional use4. OK but still with obvious design flaw

All made in China. The owner (Chinese Canadian it so happens, and a big believer in locally made, locally sourced products) said it's often hard to stock better quality items. So it's about choice. Often we can't even *choose* to reject bad quality.

Mark and Judd, I think you're both right. Generally, build quality (in terms of solidity of materials, and how long-lasting something is designed to be) is decreasing in consumer goods. But in terms of features, modernity, advanced tech and that sort of thing, bang for the buck is increasing dramatically.

In other words, you can now buy a 1080p up-sampling DVD player with 7.1 surround output, ability to play data discs in all kinds of audio & video formats, as well as audio CDs, from a good brand for maybe $60-70. But the build quality is poor, the case is thin sheet metal, the disc tray is flimsy, thin plastic, and it's only designed to last for 5-6 years.

Likewise, you can buy an inkjet printer that prints beautiful photo-quality prints -- something that would have been unimaginable just a decade ago -- for under $100, but the thing is made of cheap plastic and certainly won't last 5 years. It's essentially disposable, like a Bic lighter of years past was not worth refilling.

5. Americans in general are eating too many calories, too much sugar, not exercising enough, smoking too much, drinking too much alcohol, getting too fat, and these problems are becoming worse very quickly. People with these problems have more health problems, both trivial and serious, and require more hospitalization, more surgery, more ambulance rides, and by a huge margin more prescription drugs, than ever before.